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重型再生障碍性贫血输注中性粒细胞后自发缓解1例并文献复习

Spontaneous remission of severe aplasia anemia following granulocyte transfusion:one case report and literature review

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【作者】 方宝枝周海侠何广胜常伟荣吴德沛孙爱宁

【Author】 FANG Baozhi ZHOU Haixia HE Guangsheng CHANG WeirongWU Depei SUN Aining(The First Affiliated Hospital of Soochow University,Jiangsu Institute of Hematology,Key Laboratory of Thrombosis and Hemostasis,Ministry of Health,Suzhou,Jiangsu,215006,China)

【机构】 苏州大学附属第一医院江苏省血液病研究所卫生部血栓与止血重点实验室

【摘要】 目的:总结1例重型再生障碍性贫血(SAA)中性粒细胞输注后自发缓解病例的诊疗体会。方法:对1例SAA患者输注中性粒细胞3次自发缓解前后的临床资料进行分析,并复习国内外相关文献。结果:SAA患者并发严重的肺部感染,首次输注亲缘供体中性粒细胞2周后,白细胞和血红蛋白逐步恢复正常,但血小板始终维持在50×109/L左右。7个月后SAA复发,并再次发生严重肺感染,输注另一亲缘供体的中性粒细胞后,患者再次缓解。但在再次停用免疫抑制药的5个月后,患者出现SAA的又一次复发,又一次输注另一亲缘供体的中性粒细胞后,血常规现在恢复中。结论:SAA患者在中性粒细胞输注后,虽获得自发缓解,但随后仍需要免疫抑制治疗来维持。中性粒细胞输注导致SAA自发缓解的确切机制值得进一步的研究。

【Abstract】 Objective:To report one case of spontaneous remission of severe aplasia anemia(SAA) following granulocyte transfusion. Method:This patient’s clinical information before and after granulocyte transfusion was analyzed.The relevant litertures were reviewed.Result:This patient achieved third time spontaneous remission after granulocyte transfusion from related donor.Before the first transfusion,the patient suffered from severe pneumonia.After granulocyte transfusion,his leukocyte count and hemoglobin level gradually returned to normal levels in 2 weeks,but platelet count maintained at the level of 50×109/L.Seven months later,a month after the withdrawal of immunosuppressive therapy,SAA relapse,and pneumonia appeared again,he fortunately achieved remission again after granulocyte transfusion from another related donor.The twice relapse happened in five months later of withdrawal of immunosuppressive therapy.After the third time of granulocyte transfusion from another related donor,his blood cell counts were keeping increasing. Conclusion:SAA patients still need further immunosuppressive therapy even when they achieve spontaneous remission after granulocyte transfusion from related donor.The exact mechanism of spontaneous remission is worthy of further study.

【基金】 国家科技支撑计划(No:2008BAI61B02);国家科技重大专项课题(No:2008ZX09312-026);江苏省高校自然科学研究项目(No:09KJB320015);江苏高校优势学科建设工程资助项目;江苏省医学重点人才
  • 【文献出处】 临床血液学杂志 ,Journal of Clinical Hematology , 编辑部邮箱 ,2012年01期
  • 【分类号】R556.5
  • 【被引频次】1
  • 【下载频次】120
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